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Factors Affecting the Choice to Specialize in Medical Toxicology

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Medical toxicology is a small but growing specialty. To ensure that the specialty continues to grow and attract strong candidates, it is important to understand what influences physicians to pursue medical toxicology training. This would allow for targeted interventions to recruit strong candidates to the field.


A cross-sectional survey was sent via email to current medical toxicology fellows and to medical toxicologists who completed fellowship in the last 5 years. ACMT listservs were utilized to target recipients. The survey was created through an iterative writing process among the study authors. Responses to the survey were recorded in REDCap. Descriptive statistics were obtained and analyzed.


A total of 126 participants responded to the survey request (46 fellows and 80 recent graduates). Most were primarily trained in emergency medicine. Interest in medical toxicology usually started during residency when exposure to the field was highest. Most respondents cite a mentor as a primary influence in pursuing medical toxicology training.


Among current fellows and recent graduates of medical toxicology, having a mentor in the field of medical toxicology, having exposure to medical toxicology during residency, and participating in a clinical rotation in medical toxicology were common shared experiences that led to the decision to subspecialize in the field. These results may guide targeted intervention to continue to recruit strong candidates to medical toxicology.

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Correspondence to Michael Keenan.

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The views and opinions expressed in this article/presentation are those of the author(s) and do not necessarily reflect official policy or position of the United States Air Force, Defense Health Agency, Department of Defense, or U.S. Government.

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Supervising Editor: Trevonne M. Thompson

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Data in this study were presented at the American College of Medical Toxicology (ACMT) Annual Scientific Meeting in San Diego, CA, April 2023.

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Keenan, M., Titelbaum, N., Suen, K. et al. Factors Affecting the Choice to Specialize in Medical Toxicology. J. Med. Toxicol. 19, 389–397 (2023).

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